Seniors are completing advance directives in record numbers, but this is not having the expected effect of shifting people from hospitals to hospices in their last days, say researchers from the University of Michigan and the Veterans Affairs Ann Arbor Healthcare System.

When I lived in Baltimore, a stray, mangy cat adopted us. I am not trying to equate my cat with someone's parent, but I was reminded of Minou's last days when reading the dissertation of Mariette Klein on dementia caregivers. Specifically, how hard it can be to know what healthcare decisions to make for a loved one.

Residents of long-term care facilities who are cognitively impaired and on feeding tubes have high numbers of potentially preventable emergency room visits and hospitalizations, according to newly published research findings.

Nursing homes should adopt evidence-based approaches to pressure ulcer prevention and treatment, but significantly more research is needed to support this goal, a professor of geriatric medicine said in November.

CMS recently made changes to surveyor guidance on feeding tubes. Nursing homes must look at their policies, documentation and education practices in order to assess whether a feeding tube is appropriate.

As leaders in post-acute care, we need to stay abreast of the regulatory changes and its impact on our operations. In healthcare the one thing that remains consistent is change! Effective December 1, 2012, there are a series of Survey and Certification Memorandums from CMS that affect clinical provision of care as well as survey process changes.